David Lubarsky, MD, MBA, serves as CEO and vice chancellor of human health services at Sacramento, Calif.-based University of California Davis Health.
Dr. Lubarsky will serve on the panel "What Will Add the Most Value to Healthcare Organizations in the Next 3 Years" at Becker's 10th Annual CEO + CFO Roundtable. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the roundtable, which will take place in Chicago from Nov. 7-10, 2022.
To learn more about the conference and Dr. Lubarsky's session, click here.
Becker's Healthcare aims to foster peer-to-peer conversation between healthcare's brightest leaders and thinkers. In that vein, responses to our Speaker Series are published straight from interviewees. Here is what our speakers had to say.
Question: What is the smartest thing you've done in the last year to set your system up for success?
Dr. Lubarsky: UC Davis Health has consistently pursued the idea that we are here to “complete, not compete” with other healthcare providers. This has been especially important during the pandemic, and over the last year as we’ve worked to serve as a resource for the entire northern California region and not act as a black hole of patient referrals. Our goals are now targeted to worry less about every last dollar of referrals and instead to collaborate with ‘competitors’ so they can take on the needs of our lower-acuity patients, while we focus on delivering the high-intensity care for high-CMI patients (those with more complex medical needs) that we are built to deliver. Through these efforts, we have increased our patient acuity level from 1.9 to 2.25 in the last three years. UC Davis Health has a T/Q catchment that covers a very large area: 33 counties and about six million people in northern California and the Central Valley. Our far-flung patients cannot easily afford to take days off from work to travel here for much needed care, so we are positioning ourselves on the leading edge of virtual health which helps us to better serve more people and reduce the carbon footprint of care delivery.
Q: What are you most excited about right now and what makes you nervous?
DL: One of the pandemic’s lessons is hospitals have to be more flexible in their ability to adapt to patient care needs. The hospital of the future will have to deliver superior patient outcomes with increasingly sick patients and greater provider efficiency, while becoming more sustainable, and not losing sight of improving racial and gender equity. I’m excited to finally realize the promise of technology (machine learning, augmented intelligence, etc.) to reduce low-value work for providers and provide real time monitoring to aid our march towards healthcare equity in both process and outcomes. Technology should be used to free human time up to do what we do best – connect with patients and partner with them to keep them well rather than just seeing them when something is going wrong. I’m also looking forward to technology that ensures patient care does not stop once the patient leaves the doctor’s office or the hospital – but instead continuing it into the home. Digital home care is particularly important for monitoring chronic diseases and conditions and for the type of follow-up into domestic environments that might eliminate outcome disparities. The great physician William J. Mayo said long ago, “The aim of medicine is to prevent disease and prolong life; the ideal of medicine is to eliminate the need of a physician.” That’s so true and something we need to keep in mind through the many changes coming our way now.
Q: How are you thinking about growth and investments for the next year or two?
DL: There are no shortcuts to institutional success. Providing indispensable, patient-centered services and care will never go out of style in the health industry. Neither will efficiency in delivering care and sourcing supplies. The best companies are constantly taking costs out because they are unnecessary to achieve a desired outcome not because the financials have turned bad. Healthcare mergers and acquisitions have been growing rapidly over the last several years, and much of this activity has been driven by a desire for scale with a belief that “bigger is better.” But arguably, benefits either do not materialize or are not sustainable over the long-term unless these growth opportunities are tightly aligned with a specific strategy, starting with a patient focus and community partnering. Growth must be strategic growth. Healthcare leaders need to exhibit market awareness and monitor it continuously as well as take a disciplined, proactive approach to the expansions of services. With today’s rapid industry changes, we cannot rely solely on strategies that seemed to work in the past like doing more, charging more. It’s necessary to be creative, yet pragmatic, in what can be applied from other industries experiencing the same factors. Above all, there is no substitute for leadership and doing the right thing for patients.
Q: What will healthcare executives need to be effective leaders for the next five years?
DL: We must heed the message the public has been sending to us for some time: Healthcare is too expensive. We must do more to contain and control costs, or else someone else will develop and impose cost reduction solutions on us, and we know those won’t have our same patient-first ideals in mind.
In addition, our communities have a deep interest in equitable health outcomes, especially for our underserved and vulnerable populations. The social influencers of health are broadly defined as social and environmental factors that impact patients’ health needs, and health systems need to better understand how these variables affect their patients’ health.
UC Davis is proud that, in a survey by Monigle and the American Hospital Association earlier this year, we were ranked third in the nation for commitment to diversity, equity and inclusion. DEI efforts in the workplace for staff are important so our care teams reflect the population for which they care. UC Davis is proud to be perennially named a top employer for diversity by Forbes.
Physician and staff wellness and issues of provider burnout are critical as well. Here is where technology and AI can help as well as our employee support and human resources services. Finally, people want those who provide care to also care for the environment. Healthcare itself provides 10 percent of greenhouse gasses in the US, not to mention large amounts of plastic and other non-disposable waste. Being a sustainable organization is a priority for all University of California health systems, and UC Davis is proud to be one of the Top 25 in the US for sustainability and in the Top 10 for climate impact, according to Green Practice.
Q: How are you building resilient and diverse teams?
DL: UC Davis Health is dedicated to the full realization of our historic promise as an institution to cultivate merit, talent and achievement by supporting diversity, inclusivity and equal opportunity among our employees, students and staff. We are removing barriers to the recruitment, retention and advancement of talented people from historically excluded populations who are currently underrepresented. Toward this end, we’ve developed a support model of health equity, diversity and inclusion at all levels of UC Davis Health. One key change is we’ve revised our position descriptions for managers to ensure they don’t require a four-year college degree if an applicant’s job experience will actually suffice instead. This is in response to a historical recruitment barrier that has limited career progression for people who grew up in underserved areas but who are smart, qualified, hard-working and thereby deserving of professional opportunity. As Marian Wright Edelman, the American civil rights activist, once said, “You can’t be what you cannot see.”
Reflecting these and other efforts, UC Davis Health was named a BlackDoctor.org’s Top Hospital for Diversity in 2019, one of Latino Leaders’ Top Hospitals for Latinos in 2018, and an LGBTQ Healthcare Quality Leader in 2022 for the 11th consecutive year. Forbes ranked UC Davis Health Best Employer for Diversity in 2021 and among the best employers in California based on a survey that included questions about safety of the workplace and the employers’ openness to telecommuting – important factors amid a pandemic. Our focus on diversity, resilience and health equity means that every patient, staff member and visitor who walks through our doors is seen, heard and respected. This inclusivity is a foundational priority for us as we embrace the uniqueness of individuals and their health needs throughout our UC Davis Health community. As we build our new $4 billion hospital ICU tower, diversity is being etched into the very fabric of the building so this organizational culture is truly embedded in our workplace.